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Open Access 01-04-2019 | Laparoscopy | Consensus Statement

European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery

Authors: Salvador Morales-Conde, Andrea Peeters, Yannick M. Meyer, Stavros A. Antoniou, Isaías Alarcón del Agua, Alberto Arezzo, Simone Arolfo, Amir Ben Yehuda, Luigi Boni, Elisa Cassinotti, Giovanni Dapri, Tao Yang, Sofie Fransen, Antonello Forgione, Shahab Hajibandeh, Shahin Hajibandeh, Michele Mazzola, Marco Migliore, Christof Mittermair, Doris Mittermair, Antonio Morandeira-Rivas, Carlos Moreno-Sanz, Andrea Morlacchi, Eran Nizri, Myrthe Nuijts, Jonas Raakow, Francisco M. Sánchez-Margallo, Juan A. Sánchez-Margallo, Amir Szold, Helmut Weiss, Michael Weiss, Ricardo Zorron, Nicole D. Bouvy

Published in: Surgical Endoscopy | Issue 4/2019

Abstract

Background

Laparoscopic surgery changed the management of numerous surgical conditions. It was associated with many advantages over open surgery, such as decreased postoperative pain, faster recovery, shorter hospital stay and excellent cosmesis. Since two decades single-incision endoscopic surgery (SIES) was introduced to the surgical community. SIES could possibly result in even better postoperative outcomes than multi-port laparoscopic surgery, especially concerning cosmetic outcomes and pain. However, the single-incision surgical procedure is associated with quite some challenges.

Methods

An expert panel of surgeons has been selected and invited to participate in the preparation of the material for a consensus meeting on the topic SIES, which was held during the EAES congress in Frankfurt, June 16, 2017. The material presented during the consensus meeting was based on evidence identified through a systematic search of literature according to a pre-specified protocol. Three main topics with respect to SIES have been identified by the panel: (1) General, (2) Organ specific, (3) New development. Within each of these topics, subcategories have been defined. Evidence was graded according to the Oxford 2011 Levels of Evidence. Recommendations were made according to the GRADE criteria.

Results

In general, there is a lack of high level evidence and a lack of long-term follow-up in the field of single-incision endoscopic surgery. In selected patients, the single-incision approach seems to be safe and effective in terms of perioperative morbidity. Satisfaction with cosmesis has been established to be the main advantage of the single-incision approach. Less pain after single-incision approach compared to conventional laparoscopy seems to be considered an advantage, although it has not been consistently demonstrated across studies.

Conclusions

Considering the increased direct costs (devices, instruments and operating time) of the SIES procedure and the prolonged learning curve, wider acceptance of the procedure should be supported only after demonstration of clear benefits.

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Title: European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery
Authors: Salvador Morales-Conde
Andrea Peeters
Yannick M. Meyer
Stavros A. Antoniou
Isaías Alarcón del Agua
Alberto Arezzo
Simone Arolfo
Amir Ben Yehuda
Luigi Boni
Elisa Cassinotti
Giovanni Dapri
Tao Yang
Sofie Fransen
Antonello Forgione
Shahab Hajibandeh
Shahin Hajibandeh
Michele Mazzola
Marco Migliore
Christof Mittermair
Doris Mittermair
Antonio Morandeira-Rivas
Carlos Moreno-Sanz
Andrea Morlacchi
Eran Nizri
Myrthe Nuijts
Jonas Raakow
Francisco M. Sánchez-Margallo
Juan A. Sánchez-Margallo
Amir Szold
Helmut Weiss
Michael Weiss
Ricardo Zorron
Nicole D. Bouvy
Publication date: 01-04-2019
Publisher: Springer US
Keywords: Laparoscopy
Cholecystectomy
Incision
Published in: Surgical Endoscopy / Issue 4/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-06693-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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